What is a Medical Biller and Coder?

In healthcare administration,medical billers and coders perform interconnected roles. Billers manage the billing process, ensuring accurate charges for patients' care. Coders document the care given to patients by recording procedures, diagnoses, and treatments. Together, they maintain precise records and ensure accurate billing in the healthcare industry.

Understanding the role of a Medical Biller and Coder

Medical billing and coding are two separate jobs that have different skills. To better understand the role each plays, let's talk about their job description and responsibilities.

What is a Medical Biller?

A medical biller is a professional who handles the financial transactions within a healthcare facility. They are responsible for ensuring that healthcare providers get reimbursement for their services.

Responsibilities of a Medical Biller

Medical billers manage the billing process and do the following:

• Verifying patient information
• Reviewing medical records
• Assigning billing codes
• Submitting insurance claims
• Preparing invoices
• Collecting payments
• Following up on unpaid claims
• Coordinating with providers
• Handling patient inquiries
• Maintaining billing records

They are also responsible for resolving any billing discrepancies and ensuring that all transactions comply with healthcare laws and insurance policies.

What is a Medical Coder?

A medical coder, on the other hand, is a professional who translates medical reports into a standardized code used within the healthcare industry.

Responsibilities of a Medical Coder

Medical coders play an important role and are responsible for the following tasks:

• Reviewing medical documentation
• Assigning diagnostic codes
• Assigning procedural codes
• Ensuring code accuracy
• Researching coding guidelines
• Collaborating with healthcare providers
• Maintaining coding integrity
• Supporting claims processing
• Staying current with coding changes

The duties and responsibilities may vary based on the healthcare setting and job requirements.

A Step-by-step guide to becoming a Medical Biller or Coder

Here are some steps and prerequisites to consider if you want to become a Medical Biller and Coder:

1. Meet basic requirements: Get a high school diploma or equivalent (e.g., GED). Pass a background check to ensure you do not have a criminal history.

2. Complete training: Gain knowledge of medical terminology. Take note: training takes 4 months or longer for a certificate program and 1 to 2 years for an associate's program through a university.

3. Gain experience: Earn practical experience through internships or entry-level positions.

4. Obtain certifications: Certifications can enhance job prospects and show skill sets. Prepare and pass specific exams to get several professional certifications. The American Academy of Professional Coders (AAPC) offers Medical Billing and coding certifications. The primary medical billing certification is the Certified Professional Biller (CPB). Meanwhile, Medical Coders has five certifications to choose from, including the:

• Certified Professional Coder (CPC)
• Certified Outpatient Coder (COC)
• Certified Inpatient Coder (CIC)
• Certified Risk Adjustment Coder (CRC)
• Dual CPC and CPB

5. Update your resume: Remember to update your work experience and education. Add your certifications, training programs, and skills to become a successful Medical Biller and Coder.

6. Keep learning: Continue education to maintain certification and stay updated with industry changes.

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